Post-Finasteride Syndrome: Current Views and Where do We Stand? Medications Most Commonly Associated with Erectile Dysfunction: The Journal of Urology, May 15, 2022. Androstanediol glucoronide is a hormone derived from DHT (the hormone inhibited by finasteride). These constellations of symptoms constitute the basis for PFS in individuals predisposed to epigenetic susceptibility. A low estimated prevalence of PFS cannot be an excuse for nonvigilance since the drug is used by millions of relatively young and healthy individuals.". For the first time, we demonstrate a tissue-specific methylation pattern of SRD5A2 promoter in PFS patients [which] could represent an important mechanism of neuroactive steroid levels and behavioral disturbances previously described in PFS The SRD5A2 promoter was more frequently methylated in the CSF of PFS patients compared to controls (56.3 versus 7.7%). See? And thats huge. [T]hese data indicate the urgent need for high-quality clinical trials, with long-term follow up, specifically addressing sexual function and mood disorders. This warning is now mentioned in finasterides package insert. Aim: To determine whether (CAG)n-rs4045402 and (GGN)n-rs3138869 polymorphisms in the androgen receptor (AR) gene are implicated in PFS. But I am actually not interested in you. Post-Finasteride Syndrome Exists!! There are some nice recovery stories on TR. A Letter Regarding Finasteride: SouthBayRetina.com, May 2021. So far I tread Clomid and nolvadex cycles but I only had one day where libido returned, rest of time didnt feel anything good or bad when on it. What do you think about a PCT strategy to see if that helps? Many have never recovered sexual functioning, not worth the risk. But now I would not feel comfortable recommending Propecia to a young, sexually active man. Health Canada recently recommended adding a warning to products containing [finasteride] While being administered the above-mentioned drug, patients may develop muscle weakness and stiffness, which in turn may cause pain to the patient, damage to muscle tissue and an increase in kinase enzymes. How to Deal with the Issues of Fertility, Malignancies, and the Postfinasteride Syndrome while Prescribing Finasteride for Male Pattern Hair Loss. Literally a drug looking for any reason to still exist. Epub 2021 Sep 16. In a cohort of men prescribed finasteride for routine treatment of AGA, most would have been excluded from the pivotal studies that supported US Food and Drug Administration approval for AGA. Thanks for citing our work [Dr. Faysal]. If prolactin is high, dopamine is most likely low and serotonin elevated, so then it would be good to focus on lowering prolactin. Using finasteride for hair loss is like shooting at sparrows with cannons. Le Figaro, March 3, 2019. Yes After nearly 4 years of suffering, I have finally & fully recovered from Post Finasteride Syndrome All my symptoms have subsided and improved with this method which takes a while but I am fully functional It's H.C.G (HCG) dosed at 250IU Monday, Wednesday and Friday only. Keywords: Even if you take just a little finasteride, it can actually drop your DHT so low that men become impotent. Statement (via Twitter) to research colleague, Statement via Twitter to fellow clinicians. If cortisol is low in blood tests, then you can focus on increasing that, but if cortisol is low in saliva tests but high in blood tests, focus on calming the adrenals. What Was the Cause? Allopregnanolone, the Neuromodulator Turned Therapeutic Agent: Thank You, Next? Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors. Keywords: Although nobody knows how many men it impacts, its effects are devastating. Its unnatural for adult men to have low levels of this molecule. Access this article for 1 day for:38 / $45 / 42 (excludes VAT). Careers. [O]ur results showed that [finasteride] treatment affected the expression of a number of accumbal proteins involved in key functional processes, such as regulation of GABAergic neurotransmission, as well as steroid and pyrimidine metabolism. As I read websites like yours and CDsNuts. Yes, in general its safer with less sides, but some people have reported similar side effects as fin. 2021 Nov;7(6):524-526. doi: 10.1159/000514365. For those who argue that there is no data to support thisAs the saying goes, the absence of evidence is not the evidence of absence. Dont let any man you know take that poison! sharing sensitive information, make sure youre on a federal There was circumstantial evidence that PFS may represent a delusional disorder of the somatic type, possibly on a background of a histrionic personality disorder, which would explain the refractoriness of the condition and a high degree of suggestibility. What Is Post-Finasteride Syndrome? This site needs JavaScript to work properly. What few people know is that there are 5-R and 3 types of 5-R enzymes and that theyre not only involved in the conversion of testosterone to DHT, but also in the: Many of the benefits of testosterone, such as enhanced insulin sensitivity, reduced catabolism, higher dopamine, increased thyroid hormone production, are mediated by DHT, and blocking DHT production prevents those effects/benefits. The effect of finasteride on dry eye disease, Investigative Ophthalmology & Visual Science: June 2022. >1000ng/dl Testosterone: My Step-by-Step Guide on How I Do It Naturally! Some might be upregulated and some downregulated, so you might experience heightened serotonin responses. Meanwhile, professional organizations may provide educational materials for physicians in order to increase their awareness regarding the scope of these persistent catastrophic adverse effects of finasteride and dutasteride. It scrambles your hormones, libido and cognition all over the place, right into the gutters, and leaves you feeling like an empty dysfunctional husk. Thanks in advance. Published by Elsevier Inc. All rights reserved. Healthcare Professionals should carefully monitor patients during treatment with finasteride for psychiatric symptoms (including anxiety, depression and suicidal ideation). These observations encouraged the present systematic review of the research literature pertaining to changes in mood and possible increases in suicidal ideation and behavior in association with or following treatment with finasteride This systematic review of reports concerning adverse psychiatric effects of finasteride treatment supports the conclusion that such treatment is significantly associated with risk of clinical depression, as well as high rates of sexual dysfunction and evidence of increased risk of suicidal ideation and perhaps of suicidal behavior. What is Post-Finasteride Syndrome? These findings may prove crucial to understanding the neurochemical mechanisms of FINs neuropsychiatric side effects. 3 5 The incidence of post-finasteride syndrome is unknown, as are the biological mechanisms, but we . After discontinuation, dysfunctions may remain, worsen or resolve. What do you think of TRT is PCT to recover from PFS? Persistent erectile dysfunction in men exposed to the 5-reductase inhibitors, finasteride, or dutasteride: PeerJ, March 9, 2017. Skin Appendage Disord. Discontinuation of the drug should actually make the hormones work again.but apparently, something breaks down in some men, in the prostate, in the brain, in the whole organism. Stopping finasteride treatment can cause post-finasteride syndrome. Have you tried getting loads of sunlight? Hi, no I dont have insomnia. I just picked up Gaba, im assuming this is a good idea? In December 2018, I treated scar (not his real name), a 28-year-old man who was distressed by a number of symptoms associated with finasteride, a drug he had been taking for 12 months for alopecia, as prescribed by his dermatologist. After 15 years of research i also believe mycotoxins are playing a big role in this, mycotoxins damage the grey matter in your brain which would cause dopamine issues, then a cascade of issues from hpa axis dysfunction, gut issues, hormone issues which wont go away under a complete mycotoxin detox is done. Li X, Guo Y, Lu Y, Li H, Yan S, Li H, Li Y. Transl Androl Urol. I started losing hair about 18 yrs old if that helps, Hi I got post finasteride syndrome like side effects from saw palmettherbal blend of dht natural inhibitors from amazon https://www.amazon.com/product-reviews/B004PVLWW0/ref=acr_dp_hist_2?ie=UTF8&filterByStar=two_star&reviewerType=all_reviews#reviews-filter-bar and i did blood work (rosch eclia methodology) but endos cant find anything that could cause all the side effects im dealing with. Statement (via Twitter) in response to a study titled Sexual Dysfunction in Men Taking Systemic Dermatologic Medication: A systematic review, June 6, 2019. 2019 Jan 1;99(1):12-17. doi: 10.2340/00015555-3035. We are certainly very cautious, because we see the side effects [of finasteride]. Statement (via Twitter) in response to study titled Long-Term Effects of Finasteride on Prostate Cancer Mortality, January 29, 2019. I am investigating other solutions. From frail and hypogonadal, to gaining 60lbs of muscle, boosting testosterone over 1,000ng/dl and becoming a successful entrepreneur. Patients should be informed of these risks, so that they can weigh the benefits of harms against treatment. Zhang JJ, Shi X, Wu T, Zhang MD, Tang J, Yin GM, Long Z, He LY, Qi L, Wang L. Asian J Androl. Now two months after stopping Dudasteride, my twitches and brain zaps are now greatly diminshed, insomnia is still a problem though. A Pill the Doctor Gave Me Destroyed My Life. I do not prescribe finasteride or dutasteride for sexually active patients. PFS is real. If you are unable to import citations, please contact Men who take finasteride for baldness or receding hairlines can develop sexual dysfunction. The drug.blocks not only the super hormone but also other hormones that affect thinking and psyche, mood and emotions. Drugs to shrink the prostate (dutasteride, finasteride) shouldnt be used for years on end because it can negatively impact the heart. Finasteride is phasing out of my practice. Its awful when a patient doesnt know whats happening, and takes a medication for a specific purpose, but then develops side effects that may be more damaging than its positive effects. Organizations such as the Post-Finasteride Syndrome . We report the first case of PFS in a long-standing (over 20 years) dermatotrichological practice with frequent finasteride prescription observed in a 25-year-old male following dutasteride treatment for male androgenetic alopecia. Updated Review of the Hair Loss and Prostate Drug Finasteride: Worst Pills, Best Pills, January 2020. Annals of Medical and Health Sciences Research, January 2022. Who would have thought trying to enhance the hairline would cause bigger problems! In my own practice, I see probably a half-dozen patients a year who come in with the observationHey, I was feeling fine, I went on [Propecia], and after that, I noticed these changes in my sexual health. Mens Journal: September 2015. Hi, being a young guy with PFS since 8 months this article has been very helpful to furthermore understand what is possibly going on, so thank you. Both are inconsistent. government site. Conducting RNA microarray analysis, 1,446 genes were . And it must be mentioned that there are cases in which these functions are irreversibly impaired, which means there is no recovery after discontinuation of use. In addition, it is imperative to study in detail the molecular mechanisms that cause this condition, trying to identify a possible genetic predisposition, in order to limit the burden of PFS. Michael S. Irwig, MD, Attending Endocrinologist, Mohit Khera, MD, Director, Laboratory for Andrology Research, Kian Asanad, MD, Chief Resident Physician in Urologic Surgery, Keck School of Medicine of the University of Southern California, SSMR for the American Urological Association, Professor of Medicine and Public Health, Yale-New Haven Hospital, Roger S. Ho, MD, Associate Professor of Dermatology, Founder, European Institute for Sexual Health, Max Jordan Nguemeni Tiako, MD, Resident Physician, Janet Woodcock, MD, Director of the Center for Drug Evaluation and Research, Urology Resident, Maimonides Medical Center, Brooklyn, New York, Dr. Amin Hussein Al Amiri, Assistant Undersecretary, The United Arab Emirates Ministry of Health and Community Protection, Marc Goldstein, MD, Distinguished Professor of Reproductive Medicine and Urology, Department of Urology, Icahn School of Medicine, New York, Lahey Hospital Medical Center Institute of Urology, Burlington, MA, Advanced Urology Medical, Los Angeles, California, South Bay Retina Ophthalmology Clinic, San Jose, CA, Department of Dermatology, Qassim University, Jeremy B. Sussman, MD, Associate Professor, Internal Medicine, Associate Professor of Medicine, McGill University, Alexander Pastuszak, MD, Assistant Professor of Surgery Urology, VPC Medicina Integrada, So Paulo, Brazil, The Skin Surgery Center. Sexual dysfunction and suicidal ideation that appears to result from [finasteride] are important adverse effects. Patients considering using these medications should be very careful and speak to a Urologist in person about risks, benefits, and indications of treatment. Thus, it is inappropriate to dismiss this condition. It is frequently marketed as androgen deprivation therapy for treatment for male pattern baldness. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). So thats all gone in many men, just because of finasteride. As of 2018, 15,000 cases of adverse reactions to finasteride were reported to the WHOwhich is a huge number to begin with. [A]gree. Sant report on the suicide of PFS patient Romain Mathieu: France 5 News, Nov. 24, 2016. [Propecia] has the sexual side effects, like erectile dysfunction, which can affect men for years. New Information about Post Finasteride Syndrome (PFS) October 2, 2016 At this year's ISHRS meeting in Las Vegas, Dr. Alan Jacobs a neuroendocrinologist at Duke University School of Medicine spoke on the topic of Post Finasteride Syndrome (PFS). Optimize thyroid. Finasteride is not only poorly effective, but it can lead to infertility. [Finasteride therapy] is a modification of the hormonal mechanism, which raises the question of reversibility. This is the first analysis, to our knowledge, of suicidality and psychological adverse events in association with finasteride in VigiBase, an international pharmacovigilance databaseThese findings could raise concern that younger men with alopecia may be especially at risk for suicidality compared with the general populationClinicians should pay greater attention to the psychological adverse effects of finasteride when prescribing them, especially in the younger population using the drug for hair loss. Based on data of this study, I will strong[ly] recommend to my patients [that] using finasteride has the probability of suicidehigher than 22% than no use. The treating clinician should have knowledge and awareness about the higher prevalence of depression and sexual dysfunction in the subset of men seeking treatment for AGA in comparison to the general population. No Fun. Federal government websites often end in .gov or .mil. VRT-TV, Belgium. Bring on the BIC! Finasteride USERS BEWARE!!! Lets say your DHT is low, here are the top 7 supplements you can use to increase it: If you want additional methods on increasing DHT apart from supplements, check out my comprehensive article on boosting DHT: If DHT is normal and you still feel off, mainly anxious, not confidence, shy, nervous, experiencing brain fog, etc., you might be low in allopregnanolone. In this episode, Dr. Vikram Jayaprakash and Dr. Russell Knudsen discuss the concept of post-finasteride syndrome. It depends: 36.8%, Society for the Study of Male Reproduction (via Twitter): October 11, 2022, Sobering @nypost story on Propecia users experiencing memory loss, ED, suicidal thoughts after using the drug; illustrates the challenge in postmarket Rx safety surveillance and in getting good evidence on [adverse events] from [Randomized controlled trials] [on hormone therapy], Referring, via Twitter, to Propecia users claim drug causes memory loss, ED, suicidal thoughts: August 31, 2022. Rzeszotek S, Kolasa A, Pilutin A, Misiakiewicz-Has K, Sielatycka K, Wiszniewska B. Biomedicines. Some say it's all in the mind, a made-up mythbut those who suffer from it surely know they're not just a hypochondriac. i been suffering for close to a year from just 3 weeks of usage. Much of the medical community has yet to recognize [PFS] as a real clinical entity. Every dermatologist has their own way of treating the condition. Huh? Additional information on the Post-finasteride Syndrome as well as ongoing information about treatment options can be obtained at the PFS Foundation: https://www.pfsfoundation.org. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. I cannot sustain an erection during sex, suffer from genital anesthesia and/or numbness, have muted/blocked/pleasureless orgasms when I masturbate, and suffer from brain fog, memory loss, and thinking at times. The Interplay between Finasteride-Induced Androgen Imbalance, Endoplasmic Reticulum Stress, Oxidative Stress, and Liver Disorders in Paternal and Filial Generation. [F]inasteride is associated with common adverse health effects in women with long-term treatment for androgenetic alopecia, such as irregular menstrual cycle, aromatase disorder, high cholesterol, heavy menstrual bleeding and induced DNA damage. Acta Derm Venereol. Yes TRT does seem to help people, but dont solve everything. Chronic insomnia , I am now taking Trazodone which helps me get to sleep, I also have myoclonic twitches and brain zaps while trying to fall asleep and my auditory system is super sensitive any small noise at night makes my me jump even when wearing ear plugs. Importantly, adverse effects associated with finasteride can persist even after discontinuing its use, leading to what has been termed post-finasteride syndrome, including sexual, physical, and psychiatric symptoms, including depression, anxiety, cognitive impairment, and suicidal ideation. One key indisputable clinical evidence noted in all reported studies with finasteride and dutasteride was that use of these drugs is associated with development of sexual dysfunction, which may persist in a subset of men, irrespective of age, drug dose or duration of study. I cant answer. What Was the Cause? 8600 Rockville Pike Utah Mens Health YouTube channel: July 11, 2019. Its Monday, which means its time for a poll! Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride: JAMA Dermatology, November 2020. He Became Depressed and His Sex Drive Disappeared. Etc Etc Response (via Twitter) to medical student Rainy Horowitzs question: What sex-med topics do you think urology residents would most benefit learning about? Finasteride (Proscar, Avodart, dutasteride) is absolute garbage on a serious note! This site uses Akismet to reduce spam. The Impact of 5-Reductase Inhibitor Use for Male Pattern Hair Loss on Men's Health. Altered methylation pattern of the SRD5A2 gene in cerebrospinal fluid of post-finasteride patients: a pilot study, The Drug that Banishes Baldness Can Ruin a Mans Love Life, Post-finasteride syndrome: An emerging clinical problem, Hair Loss Drug Propecia Carries Risk of Losing Something Else, Response (via Twitter) to query by Harrison Kalodimos, MD: What are some atypical medication side effects that you have seen in practice and look out for now on a regular basis?. My private email list for written articles, exclusive offers, sales & more: http://bit.ly/2mtASGW https://gorillamind.com . TagMedicina.it, May 5, 2020. Hence, it is mandatory to ask about patients histories of preexisting depression or sexual dysfunction before starting finasteride treatment. Signs of post-finasteride syndrome (PFS) include mood swings, mental fog, depression, anxiety, erectile dysfunction, orgasm and ejaculation dysfunction. Post-finasteride syndrome is an ill defined and controversial syndrome associated with a constellation of sexual, physical, and psychological symptoms that develop during or after finasteride exposure and persist after discontinuation (box 1). Curr Urol Rep. 2018 Jun 16;19(8):65. doi: 10.1007/s11934-018-0814-z. To date, the PFS Foundation has identified 118 such professionals who have published scientific findings and/or voiced opinions on causative links between finasteride and PFS. This site needs JavaScript to work properly. Completely. In addition, there is a recognized conglomerate of sexual side effects accompanied by neuropsychiatric effects including depression that have been grouped into a term known as post-finasteride syndrome. You do think that these hypothetical damages can be reversed ? I recovered and I hope all of you suffering from PFS recover too. It can be reversed yes. government site. We probably dont have the precise data wed need to answer that. Very high levels of finasteride might then also be able to block 5R, which will reduce bile flow. Delusional disorder of the somatic type; Dutasteride; Finasteride; Histrionic personality disorder; Post-finasteride syndrome. They have muted orgasms, reduced volume of ejaculate, reduced penile sensation If it is 1.4 percent [of finasteride patients who experience persistent sexual dysfunction] and there are several million people on this product, youre looking at 300,000 men rendered impotent by a hair-loss drug. The only problem is that I have an high PROGESTERONE and High colesterol out of higher range both. Finasteride (Proscar) blocks the conversion of testosterone to dihydrotestosterone, the major male sex hormone found in cells of the prostate. Twenty percent of men who take Propecia see their sexual function diminish. The result of the blood test hormone in these patients is generally below the scale or a very low result. Here is how you focus specifically on increasing allopregnanolone: The optimal range for estrogen is around 20pg/ml and if yours is much higher, it would be best to make it a priority to lower it. 8. They barely help LUTS, cause bad sexual side effects, cause false reassurance in those with an elevated/rising PSA, and now this. Finasteride-induced Infertility (English translation): Der Arzneimittelbrief (The Drug Letter), November 2013. And they know the risks but prefer the hair. Shockwave therapy for ED. They also have problems with sex drive. Mechanisms of finasteride So let's discuss what the drug, finasteride, does in the first place. The proportion of men taking 5ARIs and experiencing erectile dysfunction is likely around 5 percent. Theoretically, you are going to block the production of hormones that serve very important behavioral purposes. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2020 Sep;204(3):602. doi: 10.1097/JU.0000000000001168.01. The most frequent non-sexual symptoms were reduced feeling of life pleasure or emotions (75.9%), lack of mental concentration (72.2%) and loss of muscle tone/mass (51.9%)Further studies are necessary to investigate the pathophysiological and biochemical pathways leading to the post-finasteride syndrome. Only individuals who are born with intersex characteristics (hermaphrodites) have low levels of this hormone. And can we talk about the real risks of cognitive decline with them??? Side effects thought to be caused by post-finasteride syndrome can be mild or serious. Treatment with finasteride and dutasteride is thought to potentially improve male pattern baldness. Although some of these side effects may go away with time, others may be permanent. There is accumulating evidence that it negatively impacts male fertility. My biggest issue is low/no libido. Int J Mol Sci. Natural solution without any success. The patient needs to know that, and to be able to say, Im stopping now. Well, SSRI drugs almost never only inhibit the reuptake of serotonin, but they often also increase allopregnanolone, decrease serotonin receptor sensitivity, block certain serotonin receptors, release dopamine and histamine, etc. Response via Twitter to statements about the Prostate Cancer Prevention Trial concluding that 5-ARIs can cause prostate cancer: May 2022. Chiriac G, Cauci S, Mazzon G, Trombetta C. Andrology. Thank you so much for your time. A few good ways to lower serotonin include: For a more comprehensive guide on lowering serotonin, check out this article: Apart from just focusing on hormones and neurotransmitters, you can also focus on diet and lifestyle.
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